1. Facial tics, rapid blinking eyes and twitches of the mouth begin by around age seven.
2. Involuntary sounds like throat clearing and sniffing or tics of the limbs may be the initial signs.
There are thought to be many factors that act as triggers for tics, however, no one specific cause has been
confirmed despite the evidence which states that the disorder stems from the abnormal metabolism of at least
one brain chemical (neurotransmitter) called dopamine.
Some existing triggers for tics:
1. Discussing TS with the student who has TS
2. Increased concentration on symptoms
3. Stress
Simple tics:
Motor -- Eye blinking, shoulder shrugging, head jerking, arm thrusting and facial grimacing.
Vocal -- Throat clearing, sniffing, barking, whistling, tongue clicking and other noises.
Complex tics:
Motor -- Jumping, touching other people or things, smelling fingers or objects, twirling about and self-
injurious actions including hitting and biting oneself.
Vocal -- Uttering ordinary words or phrases out of context, echolalia (repeating a sound, word, or phrase
just heard) and in about a third of TS cases, coprolalia (vocalizing socially unacceptable words).
Obsessions: consist of repetitive unwanted or bothersome intrusive thoughts, displaying controlling and
perfectionist type personalities. Prevalence rate: 28% - 90% of children with TS experience Obsessive
compulsive disorder (OCD).
Compulsive behaviours: consist of repetitive actions where the person feels that something must be done over
and over often in a very specific manner. E.g. touching an object with one hand after touching it with the other
hand to "even things up."
Attention deficit hyperactivity disorder: signs of ADHD may appear before the first symptoms of TS.
Indication of ADHD may include: difficulty in concentrating, failing to finish what is started, not seeming to
listen, being easily distracted, often acting before thinking, easily overwhelmed and frustrated, shifting
constantly from one activity to another, needing a great deal of supervision, and general fidgeting. Prevalence
rate: 50% - 83% of children with TS experience ADHD.
Learning disabilities: such as dyslexia, reading, writing, and perceptual difficulties, problems with
visual/motor integration occur in approximately 15% of TS individuals seen in clinical settings.
Behaviour problems: may result from OCD traits, attention problems, self esteem issues to TS symptoms,
and poor school performance.
Sleep disorders: occur in approximately 20% of the clinical TS population may include talking or walking in
ones sleep, delayed sleep onset and frequent awakenings.
Tourette Syndrome Association of Ontario